Sa. Sternberg et al., Undetected dementia in community-dwelling older people: The Canadian studyof health and aging, J AM GER SO, 48(11), 2000, pp. 1430-1434
Citations number
27
Categorie Soggetti
Public Health & Health Care Science","General & Internal Medicine
OBJECTIVE: To estimate the frequency and correlates of undetected dementia
in community-dwelling older people.
DESIGN: Secondary analysis of data from the Canadian Study of Health and Ag
ing (CSHA) prevalence survey of dementia.
SETTING: All 10 provinces of Canada excluding Indian reserves and military
units.
PARTICIPANTS: A total of 252 community-dwelling older adults diagnosed with
dementia in the CSHA survey.
MAIN OUTCOME MEASURE: Undetected dementia, defined as occurring in persons
who meet standard diagnostic criteria for dementia but who report never hav
ing seen a doctor for memory problems.
RESULTS: Of the 252 subjects, 64% had undetected dementia. Subjects with mi
ld functional impairment were significantly more likely to have undetected
dementia (odds ratio = 2.4, 95% confidence interval 1.2, 5.0). Older subjec
ts and those with mild cognitive impairment showed a trend toward undetecte
d dementia, although the results did not achieve statistical significance.
Educational level, number of comorbid conditions, and degree of social supp
ort were not significantly associated with undetected dementia.
CONCLUSIONS: A large number of older persons are living in the community wi
th undetected dementia. These older people may be at significant risk for d
elirium, motor vehicle accidents, medication errors, and financial difficul
ties. As preventive strategies are developed and new cognitive enhancing th
erapies emerge, we need to reexamine our current guidelines about screening
for cognitive impairment in older adults.